Abraham Miramontes Hernandez, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

ML61565267 Issued in WA

Practice address

Wsu Internal Medicine Residency Center
1321 Colby Avenue #B3-039
Everett, WA 98201-1665

Phone

(425) 297-5234

NPI assigned

May 9, 2024

Reactivated

Feb 24, 2025

Last updated

Feb 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1699523068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVENUE SUITE B400",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-297-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WSU INTERNAL MEDICINE RESIDENCY CENTER",
            "address_2": "1321 COLBY AVENUE #B3-039",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-297-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAMONTES HERNANDEZ",
        "first_name": "ABRAHAM",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-09",
        "last_updated": "2025-02-24",
        "deactivation_date": "2025-01-10",
        "reactivation_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "ML61565267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Mingione
• Ann L Minn
• Laura A Minor, MSW, MHP, SUDP
• Taylor Danielle Minton
• Katherine Helen Miotke, DO
• Adriana Miranda
• Bek Miremis, OT
• Casey Lynn Mitchell, CPO
• David Stanley Mitchell
• James Michael Mitchell, M.A., MHC

• Student in an Organized Health Care Education/Training Program in Everett, WA
• Providers in Everett, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.